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Doctors See Danger in Letting Church Play

Ryan Church first sustained a concussion in spring training, left, after colliding with Marlon Anderson. He got another one May 20 after his head struck the knee of the Braves Yunel Escobar.Credit
Left, Barton Silverman/The New York Times; John Bazemore/Associated Press

Experts in the field of concussion management strongly criticized the Mets on Tuesday for their handling of Ryan Church, saying that he has been put at significant medical risk by continuing to play through dizziness, lethargy and headaches.

Church sustained what the team called a mild concussion on May 20 against the Braves. While sliding into second base, his head slammed into the knee of an opponent and then fell hard onto the dirt. He missed the next game, but volunteered to pinch-hit four times since.

On Tuesday, after seeing a neurologist at the Hospital for Special Surgery in New York, Church complained of continued dizziness. Rather than report to Shea Stadium for the Mets’ game against the Florida Marlins, he stayed at his Manhattan apartment. Mets General Manager Omar Minaya said Church was day to day and would be evaluated at the ballpark Wednesday, and perhaps cleared to play in the series finale.

Several experts in sports-related concussions, however, said that Church — who has told reporters that he has had a headache and has felt dizzy and tired almost every day since his injury — should not have been allowed to play at all because his symptoms had not cleared.

The experts said common guidelines for concussion management require that athletes be free of symptoms — sometimes for several days — both before and after physical exertion before they can return to competition. They also said that because Church had sustained a more severe concussion in spring training that cost him a week, the risks for him were greater.

“That’s a situation that could be very dangerous,” said Dr. Mickey Collins, assistant director of the University of Pittsburgh Center for Sports Medicine’s concussion program. “I haven’t examined this player personally, but if there were a second trauma to a person still experiencing symptoms, the risk could be much higher to a player’s health because he hasn’t healed from the first concussion.”

Dr. Robert Cantu of Brigham and Women’s Hospital in Boston, one of the nation’s leading experts in concussion management, said: “You’re playing roulette with your patient. You know the chances of him having another concussion are low, but you’re running the risk of exacerbating the symptoms that he does have. Now a person who would be asymptomatic in a week or two can have those symptoms go on for many months.”

Church was unavailable for comment Tuesday night, and members of the Mets’ medical staff were unavailable because of team policy; a Mets spokesman referred all questions to Minaya. “We’ve been cautious, and we will continue to be cautious” in the team’s handling of Church, Minaya said.

Minaya emphasized that a CT scan of Church the night of his injury showed no damage, and that a magnetic resonance imaging test Tuesday was also negative. Minaya and Manager Willie Randolph said the club had relied principally upon Church’s reports to trainers about how he felt before each game, and sometimes during it, in deciding if he was available to play.

“It’s his call,” Randolph said. He added: “He’s been feeling a little bit groggy, and most of what he feels is that uneasiness with his total, you know, mind. It’s kind of weird because he feels like he’s kind of foggy. He says he can hit, he can do that. But in the outfield, he’s unstable out there.”

Randolph added: “When you’re talking about head injuries, I’m pretty lame on that. I don’t even know how to respond to, you know, when we can put him out there.”

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Church has gone 1 for 4 as a pinch-hitter since the concussion. Before almost every game, he has told reporters of symptoms. At one point he said, “I’m just sick of feeling like this.”

Minaya said Tuesday that Church had told Mets trainers before each game that he was symptom-free. Minaya added that Church had not seen a neurologist between his exam after the injury and Tuesday’s visit.

Last year, the National Football League faced criticism for its handling of concussions, but this is the first time since then that a Major League Baseball team has been in a similar position. The Mets began having players take baseline neuropsychological tests in spring training so that they could be tested against them after an injury; however, Church did not take a test, Minaya said, because of time restrictions.

“My understanding is that it’s a long test,” he said. “If I’m not mistaken, it’s about a half-hour or more.”

Cantu said that a player experiencing Church’s symptoms would almost certainly have his reaction time impaired, leaving him at greater risk of being hit by a pitch. He said that Church, 29, would not be at risk of second-impact syndrome, which has killed or seriously injured dozens of high school football players in the last 10 years, because that result is almost unheard of outside of teenagers.

“Many people have dramatically worsened their symptoms by going from just walking around to making the jump back to sprinting or jogging,” Cantu said. “This guy didn’t run the risk of long-term brain damage by going up to bat, assuming he wouldn’t be hit in the head. But he did run the risk of having to run out a double or a triple and exacerbating his symptoms to the point where he’d be out a month or a lot more.”

Corey Koskie can testify to that. After sustaining a concussion in July 2006 while playing for the Brewers, Koskie attempted to come back despite symptoms including headaches, dizziness and nausea. He experienced far more severe symptoms for six months, and eventually had to retire.

“That’s pretty much the reason I’m here today — thinking I could play through it,” Koskie said in a telephone interview from his home in Minnesota.

Regarding Church, he added: “I think he’s nuts. He doesn’t want to get to the point where he’s not going to get better. Tell him to call me. It’s not worth it.”

A version of this article appears in print on , on Page D1 of the New York edition with the headline: Doctors See Danger in Letting Church Play. Order Reprints|Today's Paper|Subscribe